What is a breast lift (mastopexy)?
A breast lift (mastopexy) is designed to elevate a sagging breast without reducing its volume. As women age, gravity and changes in breast tissue quality result in significant second sagging (or, breast ptosis). Skin loses its elasticity and breast fat can migrate down the chest and lose its volume. This is very disconcerting for women, especially those who have suffered these changes following a pregnancy. A breast lift is very effective for re-establishing the shape and perkiness of breasts that have undergone these changes. Sometimes, an implant is also inserted to further increase the volume and size of the breast while maintaining the benefits of the lift. Dr. Panossian is happy to discuss this option with you as well during your consultation.
How is a breast lift (mastopexy) performed?
A breast lift is performed using one of three currently practiced methods. These are based mainly on the degree of breast sagging (or, breast ptosis) and the style of incision required.
For breasts with mild sagging (Grade I), a circumareolar mastopexy may be sufficient to elevate the nipple-areola complex to a more aesthetically pleasing position. In this type of surgery, an
asymmetric incision is placed around the existing nipple-areola complex. The nipple is then elevated to the new position, and the incisions are closed in a circular pattern around the the new areola.
For breasts with moderate to severe sagging (Grade II or III ptosis), a lollipop-style incision is used to gain greater elevation of the nipple-areola complex. This is also known as a vertical lift or vertical mastopexy. The areola is resized during this procedure and the descended breast tissues are elevated through the incisions. Skin is removed in a precise manner without sacrificing breast tissue and fat to augment the volume.
For extremely severe sagging, (Grade IV ptosis), an anchor-style incision is used to resuspend the breast tissues, elevate the nipple-areola complex, and eliminate redundant skin. This is the most extreme type of lift for the most extreme type of breast ptosis.
Most breasts are amenable to either the circumareolar or vertical mastopexy (lollipop–style) options. Frequently, a breast lift (mastopexy) can be combined with implant augmentation to help further enhance breast volume. Dr. Panossian will perform a thorough consultation prior to surgery in order to establish the optimal surgical plan that will match your expectations and desires.
What is the recovery?
A breast lift (mastopexy) can take between 2 and 4 hours to perform. It is routinely done in an outpatient setting. Long-acting local anesthesia is used in combination with general anesthesia to limit pain substantially in the postoperative period. You should have a friend or relative assist you in the first 24 hours after surgery. Your initial dressings will include gauze and either an elastic bandage or surgical bra. Any external stitches will be removed during the first visit. These dressings will then be replaced in the first week for a soft support bra. This will need to be worn around the clock for the next 3 to 4 weeks.
Your breasts will be bruised and swollen for the first week following surgery, however, pain is minimal. As with other breast procedures, you should plan on staying home for the first week, with very limited activities including walking, reading, and light duty around the house. Driving should be avoided during this time as well as heavy lifting or reaching above your head.
In 2 weeks, you may begin to gently increase your activity including more extensive walking, but no aggressive exercise or weight lifting. Running and other high impact activities are also to be avoided for 4 to 6 weeks.
There may be some diminished sensation in the nipples or breast skin. Much of this will go away as the swelling subsides over the next 6 weeks. Occasionally, the decreased sensation may be permanent.
What are the risks and complications?
A breast lift (especially when performing an implant augmentation as well) is not a simple surgery, but it is relatively safe in experienced hands. Nonetheless, every surgery carries an inherent set of risks and potential for complications. Sensitivity or reaction to anesthesia is a rare possibility with any procedure. Bleeding and infection can also rarely occur. Many times, these two complications are controlled with needle aspiration in the office and/or oral antibiotics. In more severe cases, it may be necessary to perform another brief surgery to drain the blood collection (or, hematoma) or clean out an infection or administration of intravenous antibiotics. When combined with an implant augmentation, the risk for requiring surgery to address these problems may be slightly higher.
Scars are commonplace for any surgical procedure. In a breast lift, the scars can sometimes be quite extensive. They can be raised or can stretch or widen over time. Dr. Panossian has developed his own technique for improving the appearance of breast scars with a combination of products and timing that have provided incredible results time and again.
Slight asymmetry is always a risk in plastic surgery. After a breast lift, there may be subtle differences between the breasts in terms of shape, size, nipple position, or decreased sensation. Once again, these are relatively rare occurrences in experienced hands.
Dr. Panossian has vast experience in minimal-scar breast lift surgery and will be happy to go over the various options during consultation. His staff is also available at all times to answer your questions and address problems, should they arise. Call today for a consultation.